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RF16 The effects of caring for young disabled children on mothers’ health and healthcare use: findings from the born in bradford cohort study
  1. SC Masefield,
  2. SL Prady,
  3. KE Pickett
  1. Health Sciences, University of York, York, UK

Abstract

Rationale Mothers of older disabled children have worse health than mothers of typically developing children but may visit the GP less about their health problems. It is unknown whether these disparities are also present during the preschool period (0–5 years). This study compared the prevalence and frequency of GP visits for symptoms of maternal ill-health in mothers of preschool children with developmental disabilities compared with other mothers.

Methods The primary care records of children in the Born in Bradford cohort study were searched for developmental disability diagnoses before the age of five. Mothers of these children were considered exposed (n=477); all other mothers unexposed (n=9,250). Bivariate and multivariate logistic regression reporting odds ratios (OR) was used to compare the prevalence of psychological distress, head and musculoskeletal (MSK) pain, and exhaustion for exposed versus unexposed mothers in the year prior and five years after the child’s birth. Bivariate and multivariate zero-inflated negative binomial regression reporting relative rate ratios (RRR) was used to compare GP visit frequency for these symptoms. Covariates were mother’s age, ethnicity, education, subjective financial status, cohabitation status and pre-natal data (in the post-natal models).

Results Prevalence varied little pre-birth. Exposed mothers were more likely than unexposed mothers to have post-natal psychological distress (34.6% exposed versus 30.2% unexposed; OR 1.23; 95% CI 1.00, 1.52) and exhaustion (19.3% versus 14.4%; 1.41; 1.11, 1.78) after the child’s birth, but not head and MSK pain (43.4% versus 39.1%; 1.17; 0.96,1.42). Adjusting for covariates did not attenuate these findings. Visit frequency also varied little pre-birth. Visits to the GP increased after the birth, and exposed mothers did not consult more frequently than unexposed: psychological distress (mean 1.1 (standard deviation 2.0) exposed versus 0.9 (2.3) unexposed; RRR 1.00; 95% confidence interval 0.83, 1.20); head and MSK pain (1.0 (1.7) versus 0.9 (1.7); 1.08; 0.83, 1.40); exhaustion (0.3 (0.6) versus 0.2 (0.5); 1.19; 0.76, 1.85). Pakistani ethnicity (versus white British) and pre-natal consultation were strongly associated with higher post-natal consultation rates.

Conclusion Mothers of young children with developmental disabilities may have an increased risk of some symptoms of ill health, but do not consult more frequently. The provision of early family-centred support and increased GP awareness of caregiver status could help identify and support those at risk.

  • Caregivers
  • disabled children
  • socioeconomic status

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